Cancer Causes: Should We Fear Alcohol, Diet, Pollution, or Something Else?

Last week, I spoke at the 9th European Beer and Health Summit in Brussels,* an academic conference that discusses the latest research into the effects of moderate alcohol consumption on health. Our position at ACSH is identical to that of the summit; that is, a person can be healthy by abstaining from alcohol or consuming it in moderation.

Strangely, there has been an effort in recent years to challenge this conventional wisdom. In this case, the conventional wisdom is correct and the challengers, who say that any alcohol whatsoever is detrimental to health, are wrong. Yet, this new view is being pushed by shoddy research and hyped by the mainstream press. Perhaps the most ridiculous example was a headline in The Guardian claiming that an extra glass of wine will shorten your life by 30 minutes.

It goes without saying that if you are a responsible consumer of alcohol, it poses few (if any) major health risks and may actually slightly improve health. (The relationship between mortality and alcohol consumption is thought to be a J-shaped curve, which means that moderate consumption appears to decrease the risk of mortality.)

What Shall We Fear: Alcohol, Diet, Pollution, or Something Else?

If there's nothing to fear from moderate alcohol consumption, what should we worry about? Let's focus on cancer, given that is the disease that disproportionately dominates the headlines. From a public health perspective, what is the biggest preventable cause of cancer? Pesticides? Poor diet? Pollution? UV light?

No, no, no, and nope. It's tobacco, by far. (See chart. Credit: American Association for Cancer Research on page 26 of its Cancer Progress Report for 2017.) The second biggest cause is obesity, and the third is infection (e.g., HPV). There are at least three points worth making.

First, our societal obsession with dieting fads and "chemicals" is utterly misguided. This chart makes it clear that scary things like bacon and artificial preservatives are not a major public health threat (at least when it comes to cancer).

Second, preventing people from acquiring or using smoking cessation tools, like vaping devices, is counterproductive to public health. Despite the recent scares (largely due to people misusing the devices), vaping is considered 95% less harmful than smoking. If all smokers switched to vaping, public health would improve overnight and cancer incidence would fall dramatically.

Third, we do not sufficiently emphasize just how important it is for people to maintain a healthy weight and to get vaccinated against cancer-causing pathogens like HPV. Once again, if every person maintained a healthy weight and was fully vaccinated, public health would improve immediately.

It's Easier to Blame than to Change

Here's the bottom line: If you're a smoker, you need to stop. If you're overweight or obese, you need to lose weight. If you're young and unvaccinated against HPV, you need to get your shots.

Of course, this requires action. But it's so much easier to blame others -- Big Ag, Big Pharma, Big Food, Big Circus, or whomever -- than to make responsible lifestyle choices. Maybe that explains the media coverage.

*Full disclosure: My flight and hotel were paid by the conference, and I received a small honorarium.